Dental care is one of the fastest-growing retiree costs, growing by more than 16% through 2021. Unfortunately, Medicare doesn’t pay for most dental services, and it’s no coincidence that over half of all older adults in the U.S. lack dental insurance and receive no dental care because of cost. While neither Medicare nor Medigap plans offer dental coverage, older adults may be able to buy dental insurance or, at the very least, join a dental discount plan that might help lower certain costs. Here are the basics to help avoid unexpected expenses at the dentist.
- While Medicare doesn’t cover most dental costs, many Medicare Advantage plans offer some type of dental coverage. If enrolled in a Medicare Advantage plan, check the type of dental coverage offered. You may also want to compare individual policies sold by other dental insurers. Ask for dental insurance plans for seniors.
- Dental insurance works differently. Health insurance protects you from high out-of-pocket costs and often has an out-of-pocket maximum that limits what you pay. With most dental insurance, you purchase a simple dollar amount of coverage such as $1,000 or $1,500. Many dental plans come with deductibles of $50 - $100. Unlike health insurance, which may cover much of your cost once you’ve paid your deductible, dental plans tend to pay 100% only for preventive care such as exams, X-rays, and basic cleanings but pay less for more complicated services. For example, 80% for fillings, root canals, and extractions, but only 50% for the priciest procedures such as crowns, bridges, implants, and gum disease treatments. When comparing plans, anticipate your changing needs.
- Plans that charge the least are often the most restrictive about which dentist you must see. First, check the type of dental plan. Dental HMOs and even PPOs require patients to use dentists who participate in the plan networks to get savings. Find out which dentists accept your coverage and whether you need to switch dentists. Beware of dental practices that advertise that they “accept most insurances.” Get an estimate before receiving services.
- Review the plan for waiting period rules. You may need to wait one or two years to receive the costliest services in some dental plans, and your portion of the cost could still be 50%. If you know you need extensive work soon, look for fixed-price dental plans with no waiting periods, no deductibles, or dollar maximums.
- Look for free or low-cost dentists. Some nonprofit or Medicaid-funded programs provide free or reduced-cost dental services based on income. However, the services are in high demand, so you may need to get onto a waiting list. Check with local dentists to learn if they offer low-cost care one day of the month. Also, check with your local free healthcare clinics, Area Agencies on Aging, or United Way to get contact information for programs in your area.
